The presence of healed bone fractures in prehistoric skeletons is
frequently noted in palaeopathological analyses. The identification of
perimortem occurrences is less frequent, but elicits considerable
interest because of the potential to shed light on fatal events. (1)

Traumatic bone lesions can be classified into those that occurred
antemortem (with evident signs of healing), perimortem (without healing
but with apparent signs of bone damage while still 'green')
and postmortem (with signs of dry bone damage after soft-tissue
decomposition). Bone-breaking trauma in living individuals includes
violent acts, accidents, wear and tear and fractures secondary to bone
disease. (2,3) The timing of the breakage in the life of the individual
has to be considered, in addition to the cause.

Case studies are presented of antemortem and perimortem fractures
in skeletons recovered from Later Stone Age burials in southern Africa,
demonstrating trauma attributable to interpersonal violence.

Evidence of violence in the Later Stone Age (LSA) in South Africa

Patterns of bone breakage in skeletal remains in archaeological
sites in South Africa (SA), such as those studied by Morris in the
Northern Cape and Pfeiffer on the Cape coast, (4,5) are consistent with
injuries caused by accidental trauma and suggest a low incidence of such
trauma in these foraging groups. But, independent studies by Morris and
Pfeiffer have noted 10 specific cases of antemortem and perimortem
breaks consistent with violent rather than accidental trauma (Table 1).
(6,7)

In order for a bone fracture to indicate intentional violence, it
must be unlikely that it resulted from an accidental or disease process.
Such confirmation is not possible for the bulk of post-cranial breaks as
evidence of the cause of a lesion is seldom unambiguous. Only one
unambiguous case has been seen in SA, where 2 arrow points remained
embedded in the lower thoracic vertebrae of a young adult female from
Quoin Point on the southern Cape coast (Fig. 1). (8) Reconstruction of
the event indicated that the victim was likely to have been lying on the
ground in a prone position when the arrows were shot into her lower
back. (1,8) Although the exact cause of death could not be confirmed,
the unhealed wounds suggested that death occurred soon after injury.

[FIGURE 1 OMITTED]

In contrast, cranial lesions provide solid evidence of violent
intent when the nature of the impact point can be identified. In the
cases described here, Pfeiffer noted that the punctured nature of the
cranial lesions were indicative of impact with a pointed object such as
a digging stick (unlike broader lesions characteristic of an object such
as a falling rock or tree branch). (7) Although such lesions could have
been accidental, the context of the skeletons and their archaeological
association tended to confirm non-natural injury.

The same pattern of non-natural injury is true for skeletons from
Melkbosstrand and Modder River, where several individuals buried in
shared graves demonstrated unhealed cranial lesions. (9,10) A single
grave in Melkbosstrand contained the remains of an adult woman and a
juvenile; both had gashes to the cranium consistent with a blow to the
head with a linear instrument.9 Pfeiffer and van der Merwe reported the
surprising discovery of the skeletons of 3 LSA children in the Modder
River area; all bore cranial injuries inflicted with an instrument much
like a digging stick, as opposed to a sharp-edged implement, such as an
arrow or a stone knife. (10)

A comparable case of perimortem injury was found at the site of
Langklip near Hermanus on the southern Cape coast; the unpublished
excavation of the remains of 8 individuals--currently stored in the
Department of Human Biology at the University of Cape Town--was
undertaken by F. Silberbauer in 1978. The burials in a partly calcified
sand dune were recovered after disturbance, but postmortem breakages
were readily visible and distinguishable from perimortem breaks. One
healed vertebral arch fracture was evident on one of the recovered
lumbar vertebrae. The partial cranium of an adult female presented
evidence of perimortem damage, with a sharply depressed circular
fracture, representing a small impact site on the right parietal on the
quadrant nearest the bregma (Fig. 2). The striking similarity of this
lesion to those noted by Pfeiffer and van der Merwe suggested trauma
from a digging stick. (10)

Archaeological excavations on the southern Cape coast have revealed
3 cases of antemortem cranial injury in LSA foragers; all subjects
survived their insults and lived for some time afterwards.

In the first case, an old man from Snuifklip was recovered from a
consolidated sand dune at Vleesbaai, west of Mossel Bay; (11) 2
depressed fractures indicated that he had been hit over the head twice.
Although one fracture had great potential to cause serious injury, the
man survived, indicating that the brain and meninges were undamaged.
Again, the lesions were similar to those caused by a digging stick or
similarly shaped weapon. (10)

In the second case reported by Pfeiffer, antemortem injury was
noted in an adult male skeleton from a cave at Andrieskraal in the
Gamtoos Valley. (7) The individual had a depressed healed fracture on
the anterior-superior area of the right parietal bone, with cracks
extending across both parietals and the frontal bone.

The third specimen, excavated in the 1930s from Whitcher's
Cave near George, has not been described previously because of its
fragmentary nature; previous work has concentrated on the more complete
crania. Examination revealed a deeply depressed fracture on the inferior
aspect of the right parietal. Subsequent healing had rounded the
feature, confirming that the victim had survived the injury. Consistent
with the aforementioned cases, the damage was noted to be highly
localised. The impact site was rounded, although deeper anteriorly,
suggesting impact from behind (Fig. 3).

[FIGURE 2 OMITTED]

[FIGURE 3 OMITTED]

Discussion

Ethnographic evidence for the Kalahari San has been used to argue
that simple foraging communities were inherently peaceful and, wherever
possible, avoided violence in their search for conflict resolution.
(12,13) Yet historical evidence and some ethnographic data suggest that
violence was more common than previously assumed. Lee noted that
violence among San groups focused on disputes over women, and he
recorded a surprisingly large number of fatal interactions. (14) If his
data are statistically extrapolated, the murder rate among the Dobe Kung
was greater than 30/100 000. This is 3 times higher than the New York
City murder rate in the 1970s, and twice as high as the peak New York
murder rate of 14.5/100 000 in 1990. (15) It closely resembles the 2010
murder rate in Cape Town of 41.1/100 000, compared with an average
global murder rate in the same year of 6.9/100 000. (16) However, crime
statistics do not adequately explain the archaeological data. Where
personal conflict is the motive, the overwhelming majority of deaths are
of men, which is not the case in this data set of 10 individuals.

The death of the woman from Quoin Point is the least ambiguous
case; the intention of the incident could only have been to kill. (8)
All ages and both sexes are represented in the described cases, with an
apparent preponderance of females. Could these have been ritual murders?
The children from Modder River were certainly too young to have been
guilty of sexual or ritual transgressions, alluding to the idea that
they were perhaps the victims of inter- rather than intragroup violence.

Humphreys has suggested that the rich linguistic tapestry of the
Kalahari is inconsistent with territorial and band flexibility and,
instead, indicates a long period of more rigid ethnic identity with
language as a marker. (17) Although gene flow between small forager
populations is an obvious necessity to prevent inbreeding, the modern
linguistic diversity suggests that either political or geographical
separation of groups must have existed for a substantial period of time.
Humphreys proposed that languages were markers of rigid territoriality
among LSA foragers. The evidence of violence indicates that such
territoriality was actively defended.

Osteological evidence of prehistoric violence supports a model
where foraging groups did indeed behave in a manner inconsistent with
the modern ethnographic model of the gentle San. However, much research
remains to be done. Of greatest importance is the need to systematically
gather as much information as possible concerning antemortem and
perimortem fractures in the full set of LSA remains from different
places and times in southern Africa.

Accepted 15 March 2012.

Acknowledgements. I would like to acknowledge Susan Pfeiffer and
Tony Humphreys for sharing ideas and data over the years. The Research
Committee of the University of Cape Town financially supported this
project.

(4.) Morris AG. An Osteological Analysis of the Protohistoric
Populations of the Northern Cape and Western Orange Free State, South
Africa. PhD Thesis. University of the Witwatersrand, Johannesburg, 1984.

(8.) Morris AG, Parkington JE. Prehistoric homicide: a case of
violent death on the Cape south coast, South Africa. South African
Journal of Science 1982;78:167-169.

(9.) Pfeiffer S, van der Merwe NJ, Parkington JE, Yates R. Violent
human death in the past: a case from the Western Cape, South Africa.
South African Journal of Science 1999;95:137-140.

(10.) Pfeiffer S, van der Merwe NJ. Cranial injuries to Later Stone
Age children from the Modder River Mouth, Western Cape Province, South
Africa. South African Archaeological Bulletin 2004;59(180):59-65.